PROSTATE CANCER

by Yen Express


Apr 15, 2020


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Prostatic carcinoma accounts for 7% of all cancers in men and is the sixth most common cancer in the world.

PROSTATE CANCER
Prostatic carcinoma accounts for 7% of all cancers in men and is the sixth most common cancer in the world. Malignant change within the prostate becomes increasingly common with advancing age. It has been estimated that one in every six men will be diagnosed with the disease at some time in their lives . The disease is very  rare before 50 years with an increased incidence, mortality worldwide. Hormonal factors are thought to play a role in the aetiology.
Risks Factors
Age-Is common in people greater than 50 years, it’s the strongest risk factor
DHT & E2/testostereone imbalance
Family & genetic factors- is common in people that have family members previously treated for the disease 
Race- is commoner among africans
Cell behaviour and cell cycle
Other risk factors include; vasectomy before the age of 35, increase dietry fat and hormons
The spread of the disease  can either be through direct spread to the nearest organs, lympatically and haematogenously.
For understanding of the pathogenesis and stagging kindly refer to recommended text books for medicine and surgery.
Presentation 
Early stages of the disease is usually assymptomatic , while others include; 
Pain during urination
Difficulty in initiating or stopping urination
Presence of blood in urine and semen
Pain during ejaculation
Other symtoms that are commonly seen is due metastatic spread, e.g. back pain, weight loss or anaemia.
Complications
Incontinence
Bone pain and fractures
Renal failure
Erectile dysfuntion 
Metastasis
Others arise as a result of the treatment of the disease 
Investigation
The following investigations can be carried out on a patient that is diagnosed  of prostate cancer;
Digital rectal exam (DRE): feel for  tumors? increased size with nodularity.(BPH is symmetric enlargement.)
Prostate specific antigen (PSA: serum serine protease increases in cancer but also in prostatitis and ejaculation. Normal is <4 ng/mL.)
Transrectal ultrasound (TRUS): can image prostate size and nodularity Used to guide biopsy.
Prostate biopsy: several punch biopsies taken transrectally. Risks are bleeding (rectal, urinary, or ejaculatory) and infection.
CT or MRI scan for distant metastases.


Treatment
Radical prostatectomy
External beam radiotherapy (EBRT)
Brachytherapy
Orchidectomy
Complete androgen blockade

Treatment of complications that may arise as a result of the disease.


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